One of the most frequent questions that come to mind when traveling to the United States for the first time is: do I need health insurance? The answer is clear and convincing: yes, you need it! Of course, it is not mandatory (you can travel to the US without health insurance), but it is highly recommended since the costs of any small incident could be prohibitively expensive. In this post, we explain how the health system works in the USA and we guide you to hire the best travel insurance for the USA.
See all our posts about the United StatesWhy do you need travel insurance for the USA?
If you are still not sure whether or not you should take out medical insurance to travel to the United States, in the following two sections we will explain why we believe it is essential. As we said, it is not mandatory to enter the country or anything like that; It’s just an economic issue. Although most trips are usually without accidents, any misfortune in the United States can be a real ruin if you do not have insurance to take care of the expenses.
How does the US healthcare system work?
As you know, the United States lacks a public health system as we understand it in Spain (something similar to Social Security). Some state plans, such as Medicaid or Medicare, cover the most disadvantaged people or certain groups (such as those over 65), as long as they are eligible for these programs. However, most citizens (themselves and/or their companies) pay for private medical insurance that covers a large part of their medical expenses. In any case, about 16% of the population do not have any type of insurance and are forced to pay real money for each visit, test, or medicine (if they can).
Tourists, for their part, are responsible for their health and for taking out medical insurance before traveling to the United States if they want to avoid surprises. In some very rare cases, Medicaid may cover all or part of the cost of emergency care for nonresident aliens, but this unlikely help is best left out.
How much does medical care cost in the United States?
It is impossible to give an exact reference to the costs of being treated in a hospital in the United States, since it depends on each State, on the type of treatment, on hospital fees (which are not usually in the public domain), on the length of recovery and a long etcetera. In fact, it is a rather opaque subject and it is common for patients to not be able to know the cost of their interventions until they receive the invoice. According to this CNBC news, 66.5% of individual bankruptcies in the country are due to problems related to high health costs.
Surfing the net you will find many articles explaining how much medical care costs in the US, but if you look closely, the vast majority of these contents have been published by insurance companies and do not cite any official source or independent studies. Insurers are interested in raising alarms about the cost of treatments to sell you their insurance and these figures are not very reliable. But the reality is already scary enough without having to exaggerate it…
Cost of a medical consultation
How much does a routine visit to a doctor in the US cost? According to a study by the Johns Hopkins Bloomberg School of Public Health published in 2015, the average cost of consultation was $160 at the time (among patients without health insurance) and almost double for a specialist. And to this price, we should add the possible “extra” that would entail carrying out any medical test such as blood tests ($5 to $50), electrocardiograms ($50 to $150), X-rays ($300 to $750 ) or MRIs ($500 to $1,500), according to some examples taken from this website.
Cost of an emergency visit
In 2013, the Public Library of Science (PLOS) published the following list with the average costs of emergency visits based on the analysis of more than 8,000 cases.
- Sprains and strains: $1,051 ($24,000 maximum)
- Other injuries: $1,150 ($27,000 maximum)
- Open injuries to extremities: $980 ($25,000 maximum)
- Normal pregnancy and/or childbirth: $1,200 (maximum $18,000)
- Headache: $1,200 ($17,000 max)
- Back problems: €870 (maximum $10,000)
- Respiratory infection: $740 ($17,000 maximum)
- Kidney stone: $3,437 (maximum $39,408)
- Intestinal infection: $1,354 (maximum $29,551)
Although the study was published in 2013, the data was from the period 2006-2008, so you can already imagine the increase in costs from then until now. At that time the average price of an emergency visit was $1,233. Imagine today! And these prices do not include long-term treatment, admissions (which can be several thousand dollars per night), or ambulance transfers (between $400 and $1,800).
Cost of treatments with hospital admission
If things get ugly and you need to be admitted to a hospital, then the bill is going to be really expensive. According to debt.org, the median cost of a day in a US hospital was $3,949 in 2017, and the median cost of stays was $15,734. As early as 2013, a more detailed analysis by the Healthcare Cost and Utilization Project (HCUP) pointed to an average of $10,000 in spending per admission. In that same publication they revealed the average cost of some of the most common treatments:
- Heart attack: $20,246
- Septicemia: $18,031
- Respiratory problems: $17,868
- Lower limb fractures: $16,796
- Abdominal hernia: $14,447
- Minor fractures: $14,149
- Gastrointestinal disorders: $11,564
- Nervous system disorders: $11,538
- Pneumonia: $9,793
How much does insurance cost to travel to the USA?
Bearing in mind, as we have just seen, that a medical consultation could cost us about $160, a visit to the emergency room would not be less than $1,000, and a treatment that requires admission would mean a bill of no less than $10,000, with figures of up to $60,000 $ In the most serious cases (and we are no longer talking about repatriations, helicopter evacuations, medicalized planes, expenses for relatives or companions, etc.), any medical insurance for a trip to the United States is relatively “cheap”. The cheapest ones cost around €20/week and the most complete up to €80/week.
Factors that influence the price of travel insurance
- Travel time
- Coverages included
- Limits of each coverage
- Country of residence of the insured
- Coverage area (in this case, USA)
- Number of insured and ages
- Extras (adventure sports, cancellation, etc.)
- Company reputation. insurance carrier
Perhaps two of the most important aspects of this list are the limits of coverage (because, in reality, almost all insurance offers the same) and the reputation, quality, or reliability of each insurance company. Because if we are paying to be calm, we should have reliable insurance that, if necessary, can really cover high medical expenses and take care of everything quickly and efficiently.
The average price of insurance to travel to the United States
Based on searches carried out by different insurers and comparators, we have prepared this basic reference table. The price range is per person, without adding “cancellation”.
type/duration 1 week 15 days 1 month
low-cost €18-€25 €20-30 €30-40
Standard €30-€45 €35-€55 €40-70
Full €50-80 €70-€100 €80-140
The cheapest insurances usually offer medical coverage between €3,500 and $10,000. This could be enough for small incidents, but for moderately serious interventions they would fall short.
What coverage should insurance for the US have?
When hiring travel insurance for the United States (or for any other place) you will always find a breakdown of covered guarantees (or coverage) grouped into different concepts, which will normally be:
- Medical assistance, transfers, and repatriation
- delays and losses
- Cancellation (usually optional)
- Personal accidents
- Civil liability and legal defense
In the case of the US, the assistance section is the most important given the high cost of any medical intervention, from a simple consultation to a surgical operation with hospital admission. Our recommendation is that the minimum covered medical expense is $100,000.
In this first point, it is also important to check that repatriation expenses due to death or the transfer of patients are included, both for those affected and for the rest of the insured, and early return due to serious causes. Ideally, the expenses (or part of them) of moving relatives in case of serious illness, accident, or death should also be covered.
As for the accident section, the cheapest insurances do not usually include compensation for death or disability, which can reach up to €50,000 in the case of more comprehensive insurance.
Other extras that may be interesting are dental coverage or rescue expenses, normally not included in the most basic packages.
Of course, there are many more coverages that must be taken into account before contracting travel insurance, but most are self-explanatory and do not seem so sensitive in the case of the USA.